aaroho
Forum Junior
Topics: 8
Posts: 75
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A 25-year-old woman with Crohn's disease presents to your office with recurrent abdominal pain and diarrhea. She has been taking mesalamine 4 grams per day for the last year. Last fall, after developing diarrhea and pain, she was placed on prednisone 60 mg daily. She had a complete remission and, after a 3-month tapering of the prednisone, suffered a relapse. Prednisone was restarted 2 months ago at 60 mg daily, and now as the dose has decreased to 20 mg per day, the diarrhea has recurred. She is having 6 to 8 water stools per day, crampy pain, and some weight loss. What would be the best next step?
(A) Restart the prednisone and plan to maintain the dose at 40-60 mg indefinitely
(B) Restart the prednisone with 6-mercaptopurine and plan on prednisone taper in 2 months
(C) Stop the prednisone and add cyclosporine
(D) Admit to the hospital and give high-dose intravenous steroids to induce remission
(E) Stop the mesalamine and add methotrexate
(F) Book the patient for colectomy
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| neuroblastoma
Forum Guru
Topics: 99
Posts: 1,010
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(B) Restart the prednisone with 6-mercaptopurine and plan on prednisone taper in 2 months 
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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A b/c of recurrence restart pred indefinitely
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 636
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B, the pt has mod-severe disease
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| darkhorse
Forum Elite
Topics: 56
Posts: 275
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bbbbb....steroid sparing medication...6-mercaptopurine
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| darkhorse
Forum Elite
Topics: 56
Posts: 275
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bbbb...steroid sparing medication...6-mercaptopurine
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| dr.wad
Forum Senior
Topics: 3
Posts: 335
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difficult one>>>>i guess this q is prepared for specialized gastroenterologist .......could we face this q in the exam.
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